Diagnosis and staging of hepatocellular carcinoma (HCC): current guidelines.

•Surveillance based on biannual ultrasonography allows early detection of Hepatocellular Carcinoma (HCC) in patients at risk.•Only patients at risk that could be treated if diagnosed of HCC should be included in surveillance programs.•Diagnosis of HCC in early stages is key to apply effective therapy and expand life expectancy.•Typical vascular profile of HCC on imaging allows non-invasive diagnosis of HCC in patients at risk with sensitivity and specificity rates of 60% and 96–100% respectively.•The added benefit of new diagnostic tools for HCC based on MRI and PET in the decision making process is pending on robust data on specificity rates.•Treatment should be indicated only when the diagnosis of HCC is secure to avoid overtreatment of suspicious lesions.